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TORONTO (AP) - The proportion of junior hockey players who suffer concussions is far more significant than previously thought, according to a study that has researchers calling for changes to how Canada’s national game is played at all levels.

“The results of this study demonstrate an incidence of concussion significantly higher than any other study in the literature _ seven times higher,” lead investigator Dr. Paul Echlin said.

Echlin, a sports medicine specialist, said Monday the study recorded the number of concussions sustained by members of two unnamed junior hockey teams during the 2009-2010 regular season.

Seventeen players had a total of 21 concussions during 52 physician-observed games _ with almost one-quarter of those occurring among players involved in on-ice fights, say the researchers, whose study is published in the November issue of the journal Neurological Focus.

Echlin said that during the season, 29 percent of players who had a concussion went on to suffer a second or recurrent concussions _ brain injuries that have the potential to result in lifelong physical and cognitive deficits.

Also, 69 percent of the hits that caused concussions were shots to the head, he said, noting that four out of five of those were determined to be “purposeful versus incidental.”

Players who suffered a brain-rattling concussion were not able to return to the ice for almost 13 days on average. But for one-third of players, the time until they returned to the rink after their brain injury was much longer.

“There is no such thing as a minor or mild concussion,” Echlin said. “When identified and treated appropriately, we believe that most individuals … who sustain a single concussion will have a complete recovery.

“Multiple concussions, especially those associated with lack of appropriate identification and treatment, may increase the individual’s risk for adverse long-term problems.”

Paul Melia, CEO of the Canadian Centre for Ethics in Sports in Ottawa, described the incidence of concussion in the study “alarming and disturbing” and deemed it “a siren call to action for parents, for coaches, for hockey association executives at all levels in the system.”

But Melia said trying to eliminate or at least reduce the incidence of concussion in hockey _ and indeed in all contact sports _ is a social issue as much as one of health and safety for young athletes.

“And that is what makes it difficult to address head-on,” he said. “Players don’t want to appear weak or to be letting their team down. From a very young age, they’re encouraged to suck it up and play through the pain. Parents are anxious for the kids to get back on the ice. Coaches are often focused on winning ahead of athletes’ safety. The media often highlights and glorifies the gratuitous violence in the game.

“We should be making it easy for the players and the adults around them to do the right thing when it comes to concussion,” he said. “And yet it would appear that we’ve created an environment that’s doing just the opposite.”

Dr. Michael Cusimano, a neurologist at St. Michael’s Hospital in Toronto, said it’s time that leading hockey organizations _ from the NHL and Hockey Canada to the networks that broadcast games and parent and player associations _ stop talking about the dangers of concussion and start taking action to prevent it.

“The point is there are people being damaged here constantly, there are thousands every year in Canada, and the United States is no different, who are suffering brain injuries,” he said. “Is that really what we want to do?”